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Return of Organization Exempt from Income

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Return of Organization Exempt from Income PUBLIC DISCLOSURE COPY OMB No. 1545-0047 Form 990 Return of Organization Exempt From Income Tax Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) 2013 ▶ Do not enter Social Security numbers on this form as it may be made public. Open to Public Department of the Treasury Internal Revenue Service ▶ Information about Form 990 and its instructions is at www.irs.gov/form990. Inspection A For the 2013 calendar year, or tax year beginning , 2013, and ending , 20 B Check if applicable: C Name of organization LAUREL LAKE RETIREMENT COMMUNITY D Employer identification number Address change Doing Business As 34-1481142 Name change Number and street (or P.O. box if mail is not delivered to street address) Room/suite E Telephone number Initial return 200 LAUREL LAKE DRIVE (330)650-0681 Terminated City or town, state or province, country, and ZIP or foreign postal code Amended return HUDSON, OH 44236 G Gross receipts $ 25,609,783 Application pending F Name and address of principal officer: DAVID A. OSTER H(a) Is this a group return for subordinates? Yes ✔ No 200 LAUREL LAKE DRIVE, HUDSON, OH 44236 H(b) Are all subordinates included? Yes No I Tax-exempt status: ✔ 501(c)(3) 501(c) ( ) ◀ (insert no.) 4947(a)(1) or 527 If “No,” attach a list. (see instructions) J Website: ▶ WWW.LAURELLAKE.ORG H(c) Group exemption number ▶ 0928 K Form of organization: ✔ Corporation Trust Association Other ▶ L Year of formation: 1989 M State of legal domicile: OH Part I Summary 1 Briefly describe the organization’s mission or most significant activities: LAUREL LAKE EXTENDS THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES. LAUREL LAKE ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING BEHAVIORS REFLECTING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, 2 Check this box ▶ if the organization discontinued its operations or disposed of more than 25% of its net assets. 3 Number of voting members of the governing body (Part VI, line 1a) . 3 15 4 Number of independent voting members of the governing body (Part VI, line 1b) . 4 15 5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) . 5 394 6 Total number of volunteers (estimate if necessary) . 6 142 Activities & Governance 7 a Total unrelated business revenue from Part VIII, column (C), line 12 . 7a 0 b Net unrelated business taxable income from Form 990-T, line 34 . 7b 0 Prior Year Current Year 8 Contributions and grants (Part VIII, line 1h) . 144,548 616,974 9 Program service revenue (Part VIII, line 2g) . 22,940,575 23,512,172 10 Investment income (Part VIII, column (A), lines 3, 4, and 7d) . 678,385 1,480,637 Revenue 11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) . 0 0 12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 23,763,508 25,609,783 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3) . 0 0 14 Benefits paid to or for members (Part IX, column (A), line 4) . 0 0 15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 9,867,414 9,608,151 16a Professional fundraising fees (Part IX, column (A), line 11e) . 0 0 b Total fundraising expenses (Part IX, column (D), line 25) ▶ 0 Expenses 17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e) . 10,976,094 11,413,075 18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) . 20,843,508 21,021,226 19 Revenue less expenses. Subtract line 18 from line 12 . 2,920,000 4,588,557 Beginning of Current Year End of Year 20 Total assets (Part X, line 16) . 68,177,584 84,262,200 21 Total liabilities (Part X, line 26) . 61,863,601 84,262,200 Net Assets or Fund Balances 22 Net assets or fund balances. Subtract line 21 from line 20 . 6,313,983 0 Part II Signature Block Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. ▲ Sign Signature of officer Date ▲ Here DAVID A. OSTER, EXECUTIVE DIRECTOR Type or print name and title Print/Type preparer’s name Preparer's signature Date PTIN Paid Check if Preparer self-employed Use Only Firm’s name ▶ Firm's EIN ▶ Firm's address ▶ Phone no. May the IRS discuss this return with the preparer shown above? (see instructions) . Yes No For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11282Y Form 990 (2013) 11/17/2014 2:43:46 PM 1 2013 Return Laurel Lake Retirement Community, Inc. - 341481142 Form 990 (2013) Page 2 Part III Statement of Program Service Accomplishments Check if Schedule O contains a response or note to any line in this Part III . ✔ 1 Briefly describe the organization’s mission: THE PRIMARY EXEMPT PURPOSE OF LAUREL LAKE RETIREMENT COMMUNITY (LLRC) IS TO EXTEND THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH OF OUR COMMUNITIES WITH EMPHASIS ON PEOPLE WHO ARE POOR AND UNDER-SERVED. LLRC ACCOMPLISHES THIS PURPOSE BY DEMONSTRATING OUR CORE VALUES OF COMPASSION, EXCELLENCE, HUMAN DIGNITY, JUSTICE, SACREDNESS OF LIFE AND SERVICE. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? . Yes ✔ No If “Yes,” describe these new services on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services? . Yes ✔ No If “Yes,” describe these changes on Schedule O. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. 4 a (Code: ) (Expenses $ 8,691,101 including grants of $ 0 ) (Revenue $ 10,504,413 ) PROVIDE HOUSING, ENVIRONMENTAL SERVICES, AND EDUCATIONAL AND ENTERTAINMENT ACTIVITIES FOR INDEPENDENT RESIDENTS. 4b (Code: ) (Expenses $ 7,498,232 including grants of $ 0 ) (Revenue $ 9,588,759 ) PROVIDE SKILLED NURSING LONG-TERM CARE FOR RESIDENTS TO INCLUDE HOUSING, MEALS, ENVIRONMENTAL SERVICES, AND ACTIVITIES. 4 c (Code: ) (Expenses $ 3,353,580 including grants of $ 0 ) (Revenue $ 3,399,000 ) PROVIDE ASSISTED LIVING LONG-TERM CARE FOR RESIDENTS TO INCLUDE HOUSING, MEALS, ENVIRONMENTAL SERVICES, AND ACTIVITIES. 4d Other program services (Describe in Schedule O.) (Expenses $ 437,248 including grants of $ 0 ) (Revenue $ 20,000 ) 4e Total program service expenses ▶ 19,980,161 Form 990 (2013) 11/17/2014 2:43:46 PM 2 2013 Return Laurel Lake Retirement Community, Inc. - 341481142 Form 990 (2013) Page 3 Part IV Checklist of Required Schedules Yes No 1 Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A . 1 ✔ 2 Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? . 2 ✔ 3 Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I . 3 ✔ 4 Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part II . 4 ✔ 5 Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, ✔ Part III . 5 6 Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I . 6 ✔ 7 Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part II . 7 ✔ 8 Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III . 8 ✔ 9 Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IV . 9 ✔ 10 Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V . 10 ✔ 11 If the organization’s answer to any of the following questions is “Yes,” then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If “Yes,” complete Schedule D, Part VI . 11a ✔ b Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII . 11b ✔ c Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII .
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